Study of clinical and pathological correlation of AUB patients undergoing hysterectomy
Journal Title: Medpulse International Journal of Gynaecology - Year 2017, Vol 3, Issue 1
Abstract
Objective: AUB usually occurs in perior postmenopausal age group. Causes of AUB according acronym (PALM-COEIN) by FIGO (2011). They are –polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, Ovulatory dysfunction, endometrial, iatrogenic and not yet classified. Diagnosis was by clinically, investigation, ultrasonography and confirmed by histopathology. Management can be medical, minor procedures D and C, ablative procedure andhysterectomy. Methods: AUB cases (400) examined. History taken about age, parity, clinical symptoms, duration and amount of blood loss. Information about gynaecological complains, medical diseases, hormonal, operative treatment, general examination, systemic examination done and diagnosis made. CBC, RFT, TFT and Pap smear done.USG pelvis done. Endometrium sent for HP study. Hysterectomy specimens sent for HP examination. Final diagnosis compared with clinical and ultrasonography diagnosis. Results: Maximum patients were 41-50years(41.2%).Maximum AUB were multiparous around 90 % 2nd para and above. Common symptoms were HMB51.5 %.Indications was fibroid uterus 48.25 %. Endometrial biopsy was proliferativeendometrium 47.25%. Hysterectomy by abdominal route 76.75 %. Procedure was TAH and BSO. Simple endometrial hyperplasia was commonest 55.8 %. Histopathological study specimen showed leiomyoma (39.75 %). Follicular cyst ovary 40 %. Fibroid diagnostic accuracy by clinical and Sonographymethods are 78 % and 100 %. Adenomyosis diagnostic accuracy by clinical and Sonography methods are 91.2 % and 62.7%. Conclusion: Maximum patients were perimenopausal agegroup and multiparous. Common AUB symptom was HMB. Common diagnosis was leiomyoma. Diagnosis confirmed by USG and histopathology. Common endometrial patterns was proliferative. Common finding was simple endometrialhyperplasia in perimenopausal ages and complex hyperplasia in postmenopausal ages. Hysterectomy remains definite treatment in AUB patients.
Authors and Affiliations
Bharati Misra, Subhesh Kumar Bhol
Keywords
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